Heey Doc-
Quick question,
im 21 and within the last year or so i have started WSB type training, slowly at first but now i am doing the full wsb workout, my question for you is after a max effort Lowerbody series of deadlifts my right side of my neck/trap gets stiff/sore/and tight and gets progressivly worse for about three days then goes away. This has happened for 3 or 4 weaks now and i was wondering what you think it may be and what i can do to fix it
thanks in advance
[quote]Dr. Ryan wrote:
Nate Dogg,
It was nice to see you in DC. I know I enjoy making fun of you and all, but I’ve got to say you and Stacy are really good together. Sorry if that ruins your reputation.[/quote]
Thanks. 
Don’t worry about it. Stacey is a great girl, and I don’t mind having a “ruined reputation” if being in a serious relationship does that. Besides, she knows what I’m like in person and in the bedroom on a 24/7 basis. So she can still back up my rep if needed.
[quote]Now about your ankle.
The popping sound could have been caused by shifting of one of the bones causing a 'cavitation’of the associated joint. Similar to the sound of popping your knuckles. That could have caused irritation to the cartilage which could result in pain and inflammation. Obviously when dealing with an ankle, a ligament sprain should be ruled out.[/quote]
That sounds like it could be it. The irritation was pretty bad. I hobbled the rest of the day Saturday, all day Sunday and most of the day Monday. It has gotten better since.
[quote]You should ice the area 15-20 minutes every few hours for the next couple of days. Try to prop it up when you sit down. Also, try to avoid too much weight-bearing activity for a few days and see how it responds. I would suggest that you get an ankle brace to help provide support temporarily. Those canvas ones that you lace up do a good job. If it is really painful, you could use some crutches for a few days whe you have to be on your feet.
Take care,
Ryan[/quote]
Ironically, doing some speed box squats and heavy rack pulls on Monday helped my ankle by Tuesday morning. I wore an ankle brace, and it still hurt. But I was able to set myself into a stable, wide box squat position. I was able to do them just fine with little pain. The only thing I had to skip after one set were the dumbbell step ups.
I didn’t get to check the forum until today, so I missed your advice about icing it, but I have been keeping off the foot as much as possible during the day. I’m able to walk on it now with little pain. I’ll probably be okay by the weekend (in time for another football game!).
I’ve had my ankle pop/crack like this before, and it caused some pain, but never enough where walking on it was nearly impossible. Weird.
Thanks for the help!
Dr. Ryan, I’ve been having a problem with my body temp. During the day feel warm in most situations. This is no different when I go to bed. The problem is when I wake up in the morning I am freezing. I’m not talking a little cold, I can’t get warm without jumping into a hot shower. I sometimes even wake up from being so cold. (The room is obviously the same temp as the night before. )This is the polar opposite from the night. I usually have to lay there for a little while uncovered before I fall asleep. The only time this is a problem is the morning. It doesn’t matter if I’m dieting or taking supplements this always happens.
Stats: 5’9 213lbs 15% bf
I train 5 days a week and there is no correlation to training days. I am dieting now and taking Max strength HOT-ROX. Is there anything I can do? Have you heard of this before?
Well Doc, it seems that it is the long head of the biceps tendon. I failed a test where I had my arm at side with extended elbow and supinated wrist, I flexed the shoulder against resistance and felt it right at an area that indicated I was positive on the test (maybe bicipital tenosynovitis).
With that info, what kind of treatment comes to the top of your mind? What kind of progression to get the strength back? I am trying to find a better ART practitioner, mine isn’t that skilled yet, so I don’t quite trust her right now.
Thanks for all,
Rolo.
[quote]Dr. Ryan wrote:
Mastermind wrote:
Hey Doc,
A few months ago I strained my delt doing dips too fast and too low. It was only moderately bad and I worked around it with other exercises, everything seemed fine.
About three weeks back I was doing some heavy eccentrics on incline bench.
I strained it again. It isn’t any of my rotators. The strain is really on the anterior delt, really close to the medial.
I feel it when I abduct at about fifty degrees away from body, through to about 130 degrees. I feel it way more when I get to the stretch when moving my arm straight back.
I felt it would be wise to start by getting range of motion, then add light resistance in that stretch position and make it stronger there first before moving on to other movements.
Also, I’m using massage and self ART. It seems to have the range of motion back, and ten pound dumbbell raises laying on a decline bench seems okay (it is getting better, I was going to wait until it feels fine then add some weight).
What are your thoughts? Should I do anything different?
Thanks,
Rolo.
I would want to evaluate it to see what structures are involved. The long head of the biceps tendon would be one that I would want to rule out.
Yes you want to get a full pain-free ROM. However, when you start back to training you do not want to start off putting the arm in the end-range position that produced the pain and then loading it with weight. You would be better off performing the exercise with a light weight and assessing for pain or restriction throughout the ROM.
Start the resisted exerise only through the ROM that is pain-free and gradually reassess and try to add a little movement until you are able to perform the full movement.
I would suggest that you have it evaluated by a good sports med chiro or PT. They could provide some treatment and advice after doing a full exam. Self ART is ok, but usually you can’t reach all the structures you need to. The painful area may have been injured due to a biomechanical problem in a different structure.
Take care,
Ryan[/quote]
[quote]itisfinished wrote:
Hey Doc, I’m having some sort of problem with my neck/shoulder cuff. The reason I say it’s my neck is because I feel, primarily in the upper trap, a tightness and a bit of a pain, but when I pop it first thing in the morning everything seems to be ok.
It could actually be an imbalance in my upper back and rotator cuff, as when I do external rotations and any sdduction work for the scapula the next day I have relatively little to no issue with the area. It’s one of those things that the morning after a workout I woke up and my neck hurt.
I have has issues in the past with a neck sprain and muscular imbalances in my upper and mid back, and I don’t think this is any different. What do you think my course of action should be? Take time off or just try to work the elements into my current program? Thanks Doc.
[/quote]
The upper trap area is pretty much a hot bed for myofascial irritation. In addition to the traps, the levator scapulae and cervical paraspinal muscles tie into that area. Often the rounded shoulder posture and activities such as desk and computer work contribute to the problem. If it gets better following a ‘pop’, it could be me a joint issue. I would suggest that you find a good chiropractor in your area that does myofascial work in addition to just spinal adjusting. A combination of the two in addition to a good home stretching and rehab program should make a big difference. Check out the Neanderthal No More article series for info on muscle imbalance and exercise prescription.
Take care,
Ryan
[quote]AlanR wrote:
Dr. Ryan
What would be a good alternative to ART? My ART provider is excellent but I have to wait over an hour (even after making an appointment) to see him. A chiropractor who also performs ultrasound comes highly recommended but I do not know if this will address those ailments that ART can fix[/quote]
First of all, you shouldn’t have to wait that long, that is just poor scheduling and office management practices. Your time is just as valuable and the doc should be made aware that there is a problem. If this is a chronic issue and they do not wish to change, then I would call ahead and ask if the doc is on schedule or running behind and if you could adjust your schedule accordingly.
Now to your initial question, there are many docs that perform myofascial release techniques such as ART, but do not advertise it since ART is a trademarked technique. I would suggest that you just call a couple places and ask what kind of myofascial therapy they offer. Ask around and see if you get some good recommendations from other people.
Let me know if you have any other questions.
Take care,
Ryan
[quote]AG1 wrote:
Hey there Dr. Ryan…quick question.
Last spring/early summer I had some shoulder issues. Basically could not do any lateral motion on the right side. I avoided those motions for a few months and things cleared up.
Yesterday I did standing military presses and upright rows and my shoulder has been bothering me ever since. Basically any rotation hurts in the shoulder area and makes my hand tingle slightly. Any ideas?
Thanks and great avatar!
AG[/quote]
AG,
Thanks for the post, I received your PM as well. I hope the info I sent helped you with your shoulder problem and you are back to your normal training program.
It was nice to meet you in DC, you were really sweet. I’m glad I recognized you since you came incognito:)
Thank you for the nice comment on my avatar, but I can assure you, that as far as avatars go, yours is much nicer. Very sexy and classy, much like yourself. Mr. AG1 is quite the lucky guy.
Let me know if you have any other questions.
Take care,
Ryan
G’Day Dr. Ryan,
Just had a quick question for you regarding dips. Every time I perform dips I get extreme pain in my sternum. There is also pain in my clavicle area and slight pain in my upper back. After the pain has subsided a bit and I stretch my chest there is alot of cracking in the sternum area. This cracking can go on for a couple of days every time I stretch my chest. Just wondering if you have ever come across anything like this before or you could give some explanation.
Thanks for your time
I seem to keep missing you, so I’ll try again.
I’ve experienced minor back pain most of my life. I’ve always blamed it on a fall down a flight of stairs that happened when I was around eleven years old or so. I’ve never sought medical attention for it, not even when the accident occured. The pain never impedes my lifting, and lifting almost never causes it. What does cause it is performing one task in a repetitive manner for any length of time while standing in one spot. I’d hoped that strengthening my back through lifting would take care of the problem, but that hasn’t happened so far.
My question is should I seek chiropractic or some other kind of medical care for this, or are certain lifts or stretches that could alleviate the problem. The only other info I can provide is that the pain occurs in the middle of my back, just above the small of my back, and seems to wrap around the rear of the rib cage.
Thanks for your help.
Doc,
I posted a few months back about this injury but I will recap before I ask my questions.
In early October, I injured my neck grappling(head was pulled forward by a very big guy). However, leading up to the injury, I had a lot of “tension”. for lack of a better word, running from my neck into my right shoulder. Often, it felt more like shoulder pain than anything to do with the spine. I also had occasional tingling and numbness in my right hand, especially when my arm was forward from my body(such as typing on a keyboard).
The pain for a few days was severe, but eventually subsided. I had x-rays, which showed nothing. I did not have an MRI.
I was lucky enough to find a great chiro who has been working on me weekly or bi-weekly ever since. I no longer have any pain, numbness or tingling…although a little bit of that “tension” feeling comes back if I sit in a car long enough.
My problem is my strength in my right arm has gone to shit. When this happened, I couldnt do a pushup. Ive since managed to work my way up to a good number of pushups. My bench tanked. For comparison, pre-injury I was often doing singles with 350 and 3 board presses with 385. Now, a 3 board press with 225 is a huge struggle and I actually consider 135 as work sets for full range reps. Immediately after the injury, I could barely budge 135. At least now I can do 15 or 20 reps. The 225 3 board press is actually an improvement too as 185 wouldnt move 2 months ago. My right arm is still firing weak though and the bar accelerates much slower on the right side, actually causing the bar to tilt(and screwing up my groove in the process!)
Obviously, I had or have some type of nerve injury/impingement. My questions are:
Can I expect to make a full recovery
to previous levels? Am I waiting on nerve tissue to repair itself? While Im encouraged by the improvements, they’re coming slow.
How do I know that my original issues that caused this are being corrected? My chiropractor has said that Im coming along well as the pain and tingling are gone. He also says that strength is usually the last thing to return after such an injury. Is he correct in this assessment?
Where should I go from here in terms of treatment or diagnosis? Would you suggest following my current course of adjustments along with regular exercises to correct imbalances(such as subscapularis work), or is there more I should be doing? Would you recommend
I continue bench pressing while I heal?
I have been told that bench pressing occassionally causes impingements in the upper back, which would make sense as I was a bench enthusiast and did a lot of bench exercises twice a week before I got hurt.
Thanks in advance. Let me say that I appreciate the amount of time you spend here lending your expertise to strangers over the internet
Hope its not too late…Tore my left ACL (again) and wanted to go full steam into the surgery and rehab…but my bro’s weddings is at the end of April and i’m going to be the best man. Ive had both rt and lt ACL replaced so I know my timeframe for recovery (if all goes well) and I really dont want to spend a week in Florida hobbling around. Can I expect the knee to get worse if I dont have the surgery now? I only ask because I believe I re tore it months after the original surgey in 1999 but the Air Force figured sending me to physical therapy for 6 years was a good option instead of another MRI. Thanks for any help.
Doc what is a side stitch? Is it where one of your sides sticks out more than the other? If so, how can I get rid of one?
hello doc,
I have a couple problems.
First problem is the front of my left ankle. When I bent the shin forward (ie. eccentric portion of a calf raise, or leaning forward snowboarding) there is a pain in the front of the ankle joint. What did I do to it, do i have some imbalances? What can I do to correct it?
My second problem is in my right bicep. Every five days i have to unload a truck (for work)full of 40lb boxes that i have to throw or push. Over the months, I think I have gradually been pulling (if thats the right word) or straining my bicep. For a couple hours after, it is mildly sore. And if i try to train biceps later in the day, i notice the soreness again. What can I do to prepare myself better, should i be stretching my bicep? Icing it?
Thanks in advance Dr. Ryan.
Hi Dr Ryan,
A few years back I hurt my shoulder doing way too much bad swimming one day. Since then I have had issues with it, but not enough to stop me doing stuff. Sometimes more sore than others, and I generally just work around it in training. One way to make it hurt is to hold my arm above my head and then lower it out to the side when it gets about parallel to the ground or a bit lower it hurts. It can also kind of click and drop a little with some ouchy hurt.
Like I say, I’ve just worked around it. Normally as the joint warms up it hurts less. I just started doing the workout from Eric Cresseys ‘cracking the rotator cuff conundrum’ article, and for the first few reps it will hurt (it hurts moving the arm up as well as done) but after that the pain goes.
Just wondering if I’m risking making it worse, if the prehab work might help it or hinder it, and if I should actually just get it seen to or not to worry too much.
Doc, I’ve had lingering, but somewhat non-restrictive shoulder problems stemming mostly from a sublux or two during the football season. I can complete most lifts without a problem, but anything that involves supporting weight behind my head like overhead squats is painful (my OHS ROM is kind of pathetic). What sort of re-hab/exercise progression do you suggest to work up to a full ROM OHS?
Thanks,
Kyle
Dr Ryan
I have always had a weak back and have injured myself seriously about eight times doing deadlifts, romanian deadlifts, squats and good mornings (almost all with good form and reasonable weight).
I am looking to go to a specialist to see what is wrong. What would you look for qualifications-wise or job-title-wise to make sure that I don’t get a back specialist who knows nothing of weight-training or a weight-trainer who knows nothing about backs?
By the way I live in South East England.
Many thanks
Any thoughts on eating before a 15 minute HIIT session? I’ve been getting mixed reviews on this. Usually, I’ll eat ~10 gs protein 30 gs carb (350 cal) an hour or so before, then replenish after as well. Other pp have told me NOT to eat before. So what’s the rule on this and other cardio?
Thanks…
HI doc,
I have been having these on and off pains in my rib bone near the sternum around 2 inches above nipple on the left side. When i do pec stretches i can feel it a bit, pushups out of the question as the pain is pretty substantial, sneezing could be the worst feeling though… any ideas doc?
thanks!
Hey Doc,
I’ve recently been off of weight training due to several postural and joint problems that I am working on correcting.
My first problem is my shoulders (mostly my right.) I learned the hard way that my external rotators, levator scapulae and basically my entire shoulder area (besides the deltoid) is weak and undertrained. I started the 8 weeks to monster shoulders prehab program in an effort to strengthen my rotators, and I am trying to fix my posture to correct ls for internally rotated humeri and winged scapulae.
Although I would say my condition has improved, my right anterior deltoid is usually in pain, and I’m afraid that I might have a subacromial impingement. Am I on the right track doing this program?
My second question is about my hips/foot placement. I have a pretty classically imbalanced lower body-dominant quads and weak, tight hips and glutes and external foot placement (marked, but not severe.) Back when I was still lifting I would often get moderate to severe pain in my right hip, usually when squatting. This pain is still lingering. Do you know of any ways I could fix these imbalances?
R Hip Flexor injury:
Originally sustained back in October 05 when practising sprint starts. Thought it would “go away” if I laid off the sprinting (still lifting). Still there. Dull pain, soreness close to the pelvis on front of leg. Doesn’t really hurt that much. Seems more achy after squat sessions though.
Had hip rads 1m ago with Orthopod, NSF. Started seeing PT last week. They started me on some basic stretching, ice/heat, foam roller, and EMS.
I’m wondering what else you might suggest for this type of injury? I was thinking about ART, but am unsure as to whether this is also useful for a tendon type injury? I just want it better, like yesterday! Also, would you lay off lower body lifting, or just keep doing what feels comfortable? Thanks in anticipation Doc.
SRS